Compression garment

ABSTRACT

A garment ( 1 ) for providing compressive forces to a torso to help eliminate or reduce swelling caused by an accumulation of lymph fluid in the torso region. An embodiment of the present invention includes an outer covering ( 10 ) of compression fabric, wide shoulder straps ( 22, 24 ), front and back panels of compression fabric ( 12, 14, 16, 18 ), a non-rolling rib band ( 72 ), axilla gussets ( 82, 84 ), and both front closure ( 40 ) and back closure( 50 ). The garment may also include one or more princess seams ( 102, 104, 102′, 104′ ) so as to enable the front panel(s) to encapsulate and hold the user&#39;s breasts in place at the same time that compressive forces are applied, as well as one or more front shelves ( 132, 134 ) in the front panel(s) for providing upward compressive support to the breast tissue, thereby holding the tissue in a proper neutral position so that inward compressive forces acting on the tissue provide maximum effect. Through the use of the present invention, a user can provide the proper amount of compressive support that is required for each area of the torso. To wit, the user can set the adjustable closure to a desired tightness and provide up to four different levels of support over the torso region.

FIELD OF THE INVENTION

[0001] The present invention relates generally to the fields ofcompression garments and brassieres. More particularly, the presentinvention is directed to a garment for providing compressive forces to ahuman female torso so as to help eliminate or reduce swelling caused byan accumulation of lymph fluid in the torso region.

BACKGROUND OF THE INVENTION

[0002] The lymphatic system is a part of the human body's circulatorysystem. Through a complex network of lymph nodes and vessels, ittransports and removes lymph fluid, which is a clear, high proteinfluid, from the spaces between cells of the body. More specifically, thelymphatic system acts as a waste removal system for the body, removingmetabolic wastes from the body's cells and then transporting that wasteto the lymph nodes for filtering and detoxification. The “clean” lymphfluid is then returned to the bloodstream.

[0003] The lymphatic system, however, also serves as a conduit forcancerous cells to flow from a primary tumor to other sites.Consequently, lymph node biopsy is commonly used as a diagnosticprocedure to determine the status of the cancer and to check to see ifit has spread. Moreover, should the patient require surgery to removecancerous sites, a surgeon may also have to remove lymph nodes andvessels from the affected area, such as the axilla (arm pit) and breastarea in the case of breast cancer.

[0004] The removal of nodes and vessels in the affected area cancompromise the local integrity of the lymphatic system, therebyadversely impacting lymphatic drainage. Radiation therapy can alsodamage or destroy lymphatic components, thereby further contributing tolymphatic compromise. The natural aging process may also contribute tolymphatic breakdown.

[0005] Impairment of the lymphatic system can radically reduce itscapacity to transport, filter, and detoxify lymph fluid. It can alsochange the way that lymph fluid flows in that quadrant of the humanbody. Over time, sometimes years later, the lymph system can fail andfluid can back up, thereby causing swelling in a localized area. Greaterfluid retention in the tissue also increases the risk that the patientwill develop an infection, as one of the functions of the lymphaticsystem is to carry away and filter any bacteria that may be present inthe lymph fluid.

[0006] Chronic swelling caused by the accumulation of lymph fluid in anarea of the body is called lymphedema, a condition that is common amongpost-mastectomy patients and other cancer survivors who have had lymphnodes or vessels removed, or who have undergone radiation therapy.Lymphedema typically occurs in a limb (such as an arm), but it can alsooccur in the torso region, especially among breast cancer survivors. Itmay be characterized by swelling, heaviness, pain, pitting, tightness,or hardness of the tissues.

[0007] There are three stages of lymphedema, ranging from mildlymphedema, where the tissue may present with “pitting” (where thetissue, when pressed, will indent and hold the indention briefly) thatis temporary and resolves overnight, to severe lymphedema (which issometimes known as elephantitis), where the tissue increases in hardnessor fibrosis and the swelling can be disfiguring and does not reverseitself. As with most medical conditions, it is desirable that lymphedemabe diagnosed and treated as soon as possible, so as hopefully to preventor at least retard progression of the condition from the mild to severestages.

[0008] Treatment for lymphedema typically focuses on lymphatic drainagetechniques and/or the use of compression garments, although proper skincare, exercise, and, where there is an infection, antibiotic therapy,can also be important components of a treatment plan. With lymphaticdrainage techniques, which include “manual lymphatic drainage” and“simple lymphatic drainage,” the patient or a therapist gently massagesthe connective tissue in specific directions in accordance with thestructure and physiology of the lymphatic system, thereby stimulatingthe weakened system by pushing the stagnant fluid through the vessels.This also allows the venous system to reabsorb the fluid and helpsestablish channels through which lymph fluid can flow.

[0009] Compression garments may be used as an adjunct to, or as analternative for, lymphatic drainage, depending on the severity of thecondition. Compression garments are designed to apply external pressureto an affected area, thereby helping to maintain the size of that areaso that swelling remains reduced. A compression garment can also improvethe pumping of lymphatics and veins as well by creating a firm abutmentfor muscles to work against. Another benefit of a compression garment isthat it reduces local blood volume in the veins, which in turn resultsin increased velocity in the vein and greater fluid throughput.

[0010] The most common types of compression garments are compressionstockings or sleeves, which garments typically have to be expertly fitto the patient or, in some instances, custom made. Due to thecomplexities inherent in delivering the appropriate amounts ofcompression to various regions of the torso, however, few compressiongarments have been provided for use in the torso region, and even fewerexist that do not have to be custom made.

[0011] One such design is disclosed in U.S. Pat. No. 5,800,245 toBarbe-Vicuna et al. In this patent, Barbe-Vicuna et al. disclose acompression bra that uses a system of compression pads and cushions toincrease pressure at certain desired locations on the torso, therebypurportedly facilitating and/or consolidating the benefits of manuallymphatic drainage. The disclosed garment, however, does not appear todeliver any overall compression to the torso beyond that of a typicalbrassiere. Instead, the Barbe-Vicuna et al. brassiere is limited toproviding increased levels of compression at specific areas (namely, atthe sites of the compression pads).

[0012] Another garment that is designed to provide compression to awearer's breasts is disclosed in U.S. Pat. No. 5,839,942 to Miller. Inthis patent, Miller discloses a bra that is designed to treatpost-partum engorgement, enlargement, and other conditions by deliveringan adjustable level of compression, as well as by providing for theproper positioning of warm or cold compresses. The bra is fabricatedfrom two layers of resilient material to provide compression andenvelopment of the breasts. The overall design of this bra, however,would not be appropriate for the treatment of lymphedema, nor could itprovide varying amounts of compression at different areas of the torso.

[0013] Finally, a large number of garments have been provided in thepast that are designed to control breast motion (such as sports bras),provide invisible support under other garments (such as shelf bras),enhance the appearance of breasts (such as “push-up” bras), or somecombination thereof (such as most “mainstream” bras). Examples of thesegarments are disclosed in U.S. Pat. Nos. 6,168,498; 4,440,174; and5,868,601 (among others), as well as in the references cited therein.None of these garments, however, disclose the garment of the claimedinvention. Similarly, the garment disclosed in U.S. Pat. Nos. 6,086,450and 6,361,397, which supposedly facilitate the drainage of lymphaticfluid from the breast area, are far removed from Applicant's design.

SUMMARY OF THE INVENTION

[0014] The present invention is directed to a garment for providingcompressive forces to a torso to help eliminate or reduce swellingcaused by any of a variety of reasons, including without limitation anaccumulation of lymph fluid in the torso region.

[0015] One aspect of the invention is a brassiere comprising an outercovering and a front panel for providing compressive support to breasttissue. The front panel includes compression fabric and has an upperedge, a first side edge, a second side edge, and a lower edge. The frontpanel is attached to the outer covering at least at the first and secondside edges. The front panel is moveable relative to said outer coveringalong a portion of said lower edge. The brassiere also includes a frontshelf for providing upward compressive support to breast tissue. Thefront shelf is positioned proximate the lower edge of the front panel.

[0016] Another aspect of the present invention is a brassiere to be wornby a woman having axillae and an abdominal watershed, with the brassiereincluding an outer covering made from a compression fabric. The outercovering has a lower edge located about 1-8 cm above the woman'sabdominal watershed when the brassiere is properly positioned on thewoman. The brassiere also includes a pair of axilla gussets, each havingupper edges located about 3.5-5 cm below a corresponding axilla when thebrassiere is properly positioned on the woman.

[0017] Yet another aspect of the present invention is a brassiere havingan outer cover made from a compression fabric having a modulus in thelength dimension ranging from 0.5-1.5 pounds at 40% elongation and1.0-2.0 pounds at 60% elongation, a modulus in the width dimensionranging from 0.2-1.0 pounds at 40% elongation and 0.5-1.6 pounds at 60%elongation, a stretch in the length dimension ranging from 160-220% anda stretch in the width dimension ranging from 120-170%. The brassierealso includes a front portion attached to said outer cover and includinga compression fabric having a modulus in the length dimension rangingfrom 1.0-2.75 pounds at 30% elongation and 2.25-5.75 pounds at 60%elongation, a modulus in the width dimension ranging from 0.8-2.2 poundsat 40% elongation, a stretch in the length dimension ranging from135-200% and a stretch in the width dimension ranging from 115-150%.

[0018] Still another aspect of the present invention is a brassiere tobe worn by a woman having axillae, torso side regions and a breastregion, with the brassiere including first and second axilla portions,each intended to be positioned proximate one of the axillae of the womanwhen the brassiere is properly worn. The first and second axillaportions provide a first level of compressive support. The brassierealso includes side portions intended to be positioned over the woman'storso side regions. The side portions provide more compressive supportthan the first level of compressive support. Also, the brassiereincludes a front portion intended to be positioned over the woman'sbreast region. The front portion provides more compressive support thanthe side portions.

BRIEF DESCRIPTION OF THE DRAWINGS

[0019] For the purpose of illustrating the invention, the drawings showa form of the invention that is presently preferred. However, it shouldbe understood that the present invention is not limited to the precisearrangements and instrumentalities shown in the drawings, wherein:

[0020]FIG. 1 is a plan view showing the outside of an embodiment of thecompression garment of the present invention, with the garment beinglaid out flat for clarity of illustration;

[0021]FIG. 2 is a plan view showing the inside of the embodimentdepicted in FIG. 1;

[0022]FIG. 3 is a front perspective view of the embodiment depicted inFIG. 1 as it may look when being worn by a human female;

[0023]FIG. 4 is a side perspective view of the embodiment depicted inFIG. 1 as it may look when being worn by a human female;

[0024]FIG. 5 is a rear perspective view of the embodiment depicted inFIG. 1 as it may look when being worn by a human female; and

[0025]FIG. 6 is a diagram showing a typical person's superficiallymphatic drainage pathways.

DETAILED DESCRIPTION OF THE INVENTION

[0026] The present invention is directed to a garment for providingcompressive forces to a torso so as to help eliminate or reduce swellingcaused by an accumulation of lymph fluid in the torso region. An exampleof the disclosed invention as designed for a human female torso isdepicted schematically in FIGS. 1-5, although it should be understoodthat the present invention is not limited to this (or any other)particular embodiment, but rather is intended to cover all garments thatfairly fall within the broad scope of the appended claims.

[0027] Specifically with reference to FIG. 1, the disclosed compressiongarment 1 is shown laid out flat, with its outer covering 10 facing up.The outer covering 10 typically is made of a compression fabric, e.g.,such as a LYCRA®-spandex blend and generally extends over the outersurface of the entire garment, thereby acting as a sort of unifying“skin” for the garment itself. The compression fabric used for outercovering 10 is selected so as to have a modulus (pounds of holdingpower) that is adequate to achieve the desired compression, while at thesame time having a relatively large stretch. The material used in theconstruction of conventional bras is selected to adequately andcomfortably support the breasts, but does so with little if anycompression. As a related consequence, the fabric used in conventionalbras has a substantially lower modulus than that used in the compressionfabric for outer covering 10. By selecting a relatively highmodulus-high stretch compression fabric for outer covering 10, garment 1provides a relatively large amount of compression but does so with arelatively high degree of comfort.

[0028] As those skilled in the art will appreciate, the specific modulusand stretch for the compression fabric used for outer covering 10 isselected based on the specific application for which garment 1 isintended to be used. When garment 1 is intended to be used to controllymphedema, the modulus and the stretch for the compression fabric usedfor outer covering 10 will typically have the attributes listed below inTable 1: TABLE 1 Tester Stretch performed with Zwick tester at 12 poundseffective load on 3^(rd) cycle Modulus Length (pounds) 40% elongation:0.5-1.5 (typically 0.6-1.2) 60% elongation: 1.0-2.0 (typically 1.2-1.8)Width 40% elongation: 0.2-1.0 (typically 0.2-0.8) 60% elongation:0.5-1.6 (typically 0.6-1.4) Stretch Length 160-220% (typically 170-210%)Width 120-170% (typically 125-165%) Exemplary 72% 40/34 T-285 Dull“Tactel” Nylon and 28% Material 70 T-162B bright LYCRA ® spandex

[0029] The length dimension of the compression fabric is oriented inouter covering 10 so that it extends substantially parallel to thelength (vertical) dimension of garment 1 when properly worn. Theexemplary materials in Table 1 are just examples of suitable materials,and other materials satisfying the modulus and stretch characteristicslisted in Table 1 are encompassed by the present invention. Subject tothe desirability of having a relatively high extent of stretch alongwith a relatively high modulus, those skilled in the art will recognizethat if garment 1 is intended for applications other than the control oflymphedema, the compression fabric used as outer cover 10 in the presentinvention may have attributes that vary somewhat from the parameterslisted in Table 1. For aesthetic reasons, it generally is preferablethat outer covering 10 be opaque. Also, the compression fabric used forouter cover 10 preferably has effective moisture managementcharacteristics.

[0030] The outer covering 10 may be described as having front portions12 and 14, which preferably can be connected to one another by a frontclosure 40 that permits the garment 1 to be donned or removed easily bya user with restricted mobility, such as a patient suffering fromlymphedema or recovering from breast cancer surgery. While closure 40 isillustrated as a zipper in FIG. 1, the invention is not so limited. Thepresent invention encompasses any closure that achieves theaforementioned function, including, without limitation, hook-and-loopclosures such as VELCRO® closures, snaps and hook-and-eye closures.Outer covering 10 includes back portions 16 and 18, which preferably canbe connected to one other by a rear closure 50 that is designed to offermaximum adjustability so as to permit a user to customize the amount ofcompressive forces that garment 1 provides and to adjust forfluctuations in breast size. Rear closure 50 is illustrated in FIG. 1 asa multi-position hook-and-eye fastener. The present invention, however,encompasses other fasteners than hook-and-eye fasteners as rear closure50, including, without limitation, hook and- loop closures.

[0031] Shoulder strap 22 connects front portion 12 and back portion 16and shoulder strap 24 connects front portion 14 and back portion 18. Theshoulder straps 22 and 24 preferably are adjustable (such as withVELCRO® tabs), and are wider and more padded than regular brassierestraps, thus helping to redistribute breast and prosthesis weight aswell as prevent the straps from digging into a user's shoulders. In thisregard, the width of the shoulder straps 22 and 24 typically is about2-5 cm (0.8-2 inches). Moreover, the design of the shoulder straps 22and 24 is such that it helps minimize the amount of pressure at thewearer's “terminus” (an area halfway between the neck and the shoulder),which is a major lymphatic drainage area of the body.

[0032] Garment 1 typically includes side seams 32 and 34 positionedbelow the shoulder straps 22 and 24, respectively. For ease ofreference, one may regard side seams 32 and 34 as delineating the frontportions 12 and 14 of the outer covering 10 from the back portions 16and 18, even though the fabric that comprises the outer covering 10 maybe continuous across the side seams 32 and 34, rather than comprisingseparate pieces of fabric that are joined together. At the side seams 32and 34, the outer covering 10 is typically joined to the inner layer(s)of compression fabric (discussed infra) and, if the outer covering isnot continuous across the side seams 32 and 34, the front and backportions 12 and 16 and 14 and 18 may be joined to one another. In somecases, it may be desirable to omit the side seams 32 and 34.

[0033] Toward the lower edge of the garment 1, the outer covering 10 ispreferably attached to a rib band 70 at lower seams 72 and 74. The ribband 70 typically is covered by the outer covering 10. This can beaccomplished by either including another attachment seam at the loweredge 76, or wrapping a portion of the outer covering 10 around the loweredge 76 of the rib band 70 and attaching that portion of the outercovering 10 to the rib band 70 (and to the outer covering 10) at thelower seams 72 and 74. Preferably, the rib band 70 is made from anelastic material and is wide (such as is shown in FIG. 1), soft, and“non-rolling.” Rib band 70 typically has a width in the range of 2.5-7.5cm (1-3 inches).

[0034] In the arm holes defined by the shoulder straps 22 and 24,respectively, axilla gussets (or “underarm gussets”) 82 and 84 areprovided, respectively. Axilla gussets 82 and 84 are attached to theouter covering 10 at axilla seams 92 and 94. Each axilla gusset 82 and84 is preferably comprised of a layer of low-compression ornon-compression fabric that is breathable and provides for movement ofthe user's arms, with the fabric typically, but not necessarily, beingmade from a mesh or knit material. The axilla gussets 82 and 84 functionso as to improve the wearability of the garment by preventing areas offlesh from overhanging the edges of the garment. Such overhanging fleshis a typical complaint associated with many prior art garments havingaxilla edges that only extend approximately to the region of the axillaseams 92 and 94 of the disclosed design, but no further. Thus, thematerial used for axilla gussets 82 and 84 is selected to provide only alimited amount of compression to the axillae region of the user.

[0035] The material used for axilla gussets 82 and 84 is not a“compression fabric” in the sense this term is used relative to outercovering 10. Suitable modulus and stretch attributes for the materialused for axialla gussets 82 and 84 is listed below in Table 2: TABLE 2Tester Stretch and Modulus tests performed with Zwick tester at 15pounds effective load on 5^(th) cycle. Modulus Length (pounds) 60%elongation: 0.3-1.0 (typically 0.4-0.85) 80% elongation: 0.7-1.8(typically 0.8-1.65) Width 40% elongation: 0.65-1.7 (typically0.75-1.55) Stretch Length 150-200% (typically 157-193%) Width 75-115%(typically 85-105%) Exemplary 84.33% 50/34 Semi-Dull Polyester and15.67% 40 T-162B Material bright LYCRA ®

[0036] The length dimension of the fabric of Table 2 is oriented inaxilla gussets 82 and 84 so that it extends substantially parallel tothe length (vertical) dimension of garment 1 when properly worn. Theexemplary materials in Table 2 are just examples of suitable materials,and other materials satisfying the modulus and stretch characteristicslisted in Table 2 are encompassed by the present invention.

[0037] With reference to FIG. 2, the inside of the compression garment 1is shown, with the garment again being laid out flat. As will bedescribed more fully, the inside of the compression garment 1, which isthe side that contacts the user's skin, is generally covered with one ormore layers of a compression fabric that forms liner 100, which containselastic, e.g., spandex fibers. In comparison to the compression fabricused to form the outer covering 10, the compression fabric used forliner 100 is typically lighter weight, and preferably should be soft asit is designed to contact the user's skin. In addition, the compressionfabric for liner 100 generally has a higher modulus than the compressionfabric used for the outer covering 10 and typically has less stretch,thereby avoiding a situation wherein the outer covering 10 stretchesless than that of the inner layer(s), which could inhibit the functionof the inner layer(s). Further, the compression fabric for liner 100generally has good moisture management attributes, and is relativelybreathable. The compression fabric for liner 100 may have a meshconstruction, although non-mesh materials that have the desiredbreathability, softness, and stretch may also be used.

[0038] Suitable modulus and stretch attributes for compression fabricused for liner 100 are identified below in Table 3: TABLE 3 TesterStretch and modulus test performed with Zwick tester at 30 poundseffective load on 3rd cycle. Modulus Length (pounds) 30% elongation:1.0-2.75 (typically 1.15-2.5) 60% elongation: 2.25-5.75 (typically2.70-5.45) Width 40% elongation: 0.8-2.2 (typically 1.0-2.0) StretchLength 135-200% (typically 150-183%) Width 115-150% (typically 120-145%)Exemplary 72% 40/34 T-285 Semi-Dull “Tactel” Nylon and Material 28% 280T-127 Dull LYCRA ®

[0039] The length dimension of the fabric of Table 3 is oriented inliner 100 so that it extends substantially parallel to the length(vertical) dimension of garment 1 when properly worn. The exemplarymaterials in Table 3 are just examples of suitable materials, and othermaterials satisfying the modulus and stretch characteristics listed inTable 3 are encompassed by the present invention.

[0040] It is generally desirable to join the outer covering 10 to liner100 at least along a portion of the top seams 42-45, the shoulder seams52 and 54, and the center seams 62 and 64. Moreover, the outer covering10 is also preferably not attached to the liner 100 along princess seams102 and 104 in the outer covering and princess seams 102′ and 104′ inthe liner, the function of which will be described more fully infra.

[0041] For ease of reference, it may be helpful to refer to liner 100 asbeing divided up into multiple “panels,” although use of suchterminology is not meant to imply that a continuous piece of fabriccould not extend across multiple panels. Thus, one could describe liner100 as comprising two front panels 112 and 114 of compression fabric,each of which extends from a side seam 32 or 34 to a front seam 62 or64, and two back panels 116 and 118 of the compression fabric, each ofwhich extends from a side seam 32 or 34 to a back seam 36 or 38.Alternately, one could refer to the entire front region (from side seam32 to side seam 34, passing through zipper 40) and the entire backregion (from side seam 34 to side seam 32, passing through fasteners 50)as separate front and back “panels,” respectively. In the presentdescription of the invention, however, only the former nomenclature willbe used. Where appropriate, though, either or both nomenclatures may beapplicable to the claims.

[0042] Front panels 112 and 114 preferably are attached to the outercovering 10 at side seams 32 and 34, axilla seams 92 and 94, shoulderseams 52 and 54, top seams 42 and 44, and center seams 62 and 64.Preferably, each front panel 112 and 114 is comprised of two or morelayers of compression fabric, although it would be possible to use asingle layer of fabric if such fabric provided the proper amount ofcompression and stretch. Each front panel 112 and 114 may also contain aregion 119 between the layers of fabric (or a separate pocket) that isaccessible from an area near side seams 32 or 34 for receiving a breastprosthesis (not shown), such as is often used by users who have had someor most of their breast tissue removed during breast cancer surgery. Inthis regard, an opening 120 in communication with region 119 may beprovided in front panels 112 and 114, typically adjacent the side seams32 and 34, but also positionable elsewhere on the front panels.

[0043] Front panels 112 and 114 preferably are moveable relative to, andtypically not attached to, the outer covering 10 along lower edges 122and 124. Moreover, the portions of the front panels 112 and 114 near thelower edges 122 and 124 preferably are formed into two front “shelves”(or integral “shelf bras”) 132 and 134 for providing upward compressivesupport to the breast tissue, as will be described in detail infra. Thefront shelves 132 and 134, however, preferably do not extend past theside seams 32 and 34 so as to avoid producing an adverse “cutting”effect in the inferior axillae region.

[0044] Back panels 116 and 118 generally are attached to the outercovering 10 along each side of the panel, such as at side seams 32 and34, axilla seams 92 and 94, top seams 43 and 45, back seams 36 and 38,and lower seams 72 and 74. Like the front panels 112 and 114, the backpanels 116 and 118 are also preferably made from a fabric having thebreathability, softness and stretchability attributes discussed aboverelative to compression fabric 100. However, as explained infra, it isgenerally desirable that the back panels 116 and 118 provide lesscompressive force to the back of the user's torso than the front panels112 and 114 provide to the front. This can be achieved by providing onlyone layer of compression fabric in the portion of liner 100 making upthe back panels 116 and 118, although the use of additional layers fallswithin the scope of the disclosed invention. Alternatively, lesseramounts of compression may be achieved with back panels 116 and 118 byconstructing the panels with different materials and/or designs (e.g.,stitching) than that used for panels 112 and 114 so as to achieve thelesser amounts of compression.

[0045] With reference to FIGS. 3-5, the proper positioning of thedisclosed compression garment and its function in providing compressiveforces to a human female torso will now be described.

[0046] As may be seen in FIGS. 3-5, the garment 1 is designed to be wornby a user in much the same manner as a typical brassiere. The garment 1,however, preferably is designed and fitted so that the top edge of eachaxilla gusset 82 and 84 extends about 5 cm (2 inches) above a standardbra silhouette, and thus falls between approximately 3.5-5 cm (about1.5-2.0 inches) below the corresponding one of the user's axilla. Thisdistance, noted in FIG. 3 as distance D, is measured between the topedge of an axilla gusset 82, 84 and the portion of the axilla defined byan imaginary straight edge that just touches front and back portions ofthe axilla when the arm is positioned on the hip of a user, as shown inFIG. 3. In other words, the upper-most extent of distance D does notextend up into the base or inner-most part of the axilla, but ratherextends to just that portion touched by the previously mentionedstraight edge. Similarly, it is preferable that the lower edge 76 of thegarment 1 extends to about the inferior rib cage on the side of theuser's trunk, and to approximately 1-8 cm (0.5-3 inches) above theuser's naval in the front (a height noted in FIG. 3 as H), an areareferred to as the “abdominal watershed.” Typically, but notnecessarily, height H will range from 1.5-5 cm (0.6-2 inches). The backof the garment 1, shown in FIG. 5, and hence closure 50, preferablyextends from the user's waist region (at the lower edge 76), at aboutthe same height as the portion of the edge 76 adjacent closure 40, to apoint that falls within an area defined by the user's fifth and eighththoracic vertebrae (T5-T8) (at the top edges 43 and 45). In other words,the lower edge 76 is substantially coextensive with an imaginaryhorizontal plane intersecting the user and located a distance H (FIG. 3)above the user's navel.

[0047] Like all of the preferred features of the disclosed embodiment,the preferred positioning described above is not essential to thepresent invention, but rather is designed to avoid potentially sensitivepost-surgical sites and to avoid impeding the natural flow of lymphaticfluid in the body. In addition, this preferred positioning helps ensurethat the compressive support provided by the garment is directed tothose areas where the support will be most effective. The non-rollingrib band 70 generally helps anchor garment 1 in this preferredpositioning.

[0048] The compressive forces provided to the torso or the user by thegarment 1 generally are provided by the layer(s) of compressive fabricin liner 100. The outer covering 10, however, may also contribute to thecompressive effect, as well as provide stability to the garment andsupport for the inner layer(s). By design, the amount of compressivesupport generally provided by any particular region of the garment 1varies due to different fabric used in those areas, as well as the typeand disposition of the stitching used to secure the fabrics together.The amount of compression applied by garment 1 will also vary as afunction of the fit point selected by the designer of the garment. Thevarious fabric attributes listed above in Tables 1 and 3 were selectedfor a fit point at a stretch of about 20%. Those skilled in the art willappreciate that at a different fit point, somewhat different attributesfor the compression fabric used in garment 1 may be desirable.

[0049] The least amount of compressive support, which shall bedesignated a “first level” of support, is provided by the axilla gussets82 and 84, which, as noted above, are preferably fabricated from asingle layer that provides little compression. The term “level,” as usedin the description of the invention and in the claims, refers to a rangeof support, and not a single numerically quantified amount of support.The level of support may vary, from location to location, within theportion of garment 1 under consideration (e.g., within axilla gussets 82and 84), and also is intended to encompass a range of average supportacross the entire portion. As may be seen in FIG. 6, which is a diagramshowing a typical person's superficial lymphatic drainage pathways, theaxillae 200 serve as critical collection and drainage points for thelymphatic system. Thus, while some level of compression in this area isdesirable, care should be taken so as to not cut into and restrictlymphatic drainage through this region.

[0050] The next level of compressive support, or the “second level” ofsupport, generally is provided by the single layer of compressive fabric100 in the back panels 116 and 118, which, as noted above, act incombination with the outer covering 10. As one skilled in the art willreadily appreciate, of course, the amount of compressive supportprovided by the back panels 116 and 118 is not uniform over each panel,but rather tends to increase the closer one gets to a rigid seam, suchas side seams 32 and 34 and back seams 36 and 38. Indeed, as discussedbelow, the area on both sides of the side seams 32 and 34 may moreproperly be referred to as providing a “third level” of support.Nonetheless, the average amount of compression provided over the backregions from an area beginning approximately half way across each backpanel 116 and 118 and extending across the rear closure 50 is generallygreater than the amount of compression provided in the axillae regionsand is less than the average amount of compression provided in the frontand side regions (as discussed below), thus resulting in the “secondlevel” designation. Having less compressive force in this region incomparison to the amount of compression provided in the front or sidesis generally desirable because it permits the ribs to expand, allowingease of breathing, rather than constantly being in a state ofsignificant compression.

[0051] The next highest level of compressive support, or the “thirdlevel” of support, generally is provided over the user's side region,beginning at an area that for the right side (shown in FIG. 4) begins atapproximately one-third of the distance between seam 32 and seam 62, asmeasured horizontally moving from seam 32 toward seam 62, and continuesover the side seam 32 to an area approximately half way between the sideseam 32 and the back seam 36. This area is identified by bracket 140 inFIG. 2. It is desirable to provide a greater amount of compressionsupport here than in the regions of first or second level of supportbecause lymphatic fluid tends to back up in the inferior axillae region.Thus, in a user with a compromised or impaired lymphatic drainagesystem, the amount of pressure in the drainage system is greater in thisregion, therefore necessitating a greater degree of compression so as tomaintain the size of the affected area, reduce local blood volume, andimprove system efficiency by creating a firm abutment against whichmuscles can work. Such “third level” of support is also provided in theportion of the garment 1 covering the user's left side, as indicated bybracket 142 in FIG. 2.

[0052] The greatest level of compressive support, or the “fourth level”of support, generally is provided over the user's breast region. Thisregion, identified by bracket 144 in FIG. 2, extends from the outsideedge of the user's right breast (about 2.5-3.5 cm or 1-1.5 inchesoutwardly of princess seam 102′), across the closure 40, and terminatingnear the outside edge of the user's left breast (about 2.5-3.5 cm or 1inch to 1.5 inches outwardly of the princess seam 104′). The exact areawhere the “fourth level” of support transitions to the “third level”will depend on the geometry of the user, and, more particularly, on theuser's breast size. It is preferable that compression in the breastregion be the greatest because this region typically is most compromisedduring cancer treatments, thereby increasing the likelihood and severityof localized swelling.

[0053] The princess seams 102 and 104 and the front shelves 132 and 134are two of the elements of the disclosed design that help enable thefront panels 116 and 118 of the garment to provide, in combination withthe outer covering 10, the fourth level of support to the user's breastregion, although other combinations of elements may be used.

[0054] More specifically, the princess seams 102 and 104 in outercovering 10, and the princess seams 102′ and 104′ in liner 100, createconvex contours in the front panels 116 and 118 that enable the panelsto encapsulate and hold the user's breasts in place at the same timethat the combination of the compression fabric and the outer covering 10compresses the breast tissue in toward the torso on all sides. Bycomparison, a standard bra “cup” only encapsulates breast tissue; itdoes not necessarily provide for or facilitate compression.

[0055] Meanwhile, the two front shelves 132 and 134 of the front panels116 and 118 act as “floating bras” and likewise help encapsulate andcompress the user's breast tissue. In particular, the front shelves 132and 134 provide upward support to the breast tissue as well as verticalcompression that, if separately measured, is believed to beapproximately a “second level” of support. Without the use of theshelves 132 and 134 (or an acceptable alternative), the user's breastswould hang down somewhat and thus would be out of alignment whencompressed by front panels 116 and 118. With the shelves 132 and 134,however, the breast tissue is held in a proper neutral position so thatinward compressive forces acting on the tissue provide maximum effect.While the use of shelves 132 and 134 is generally desirable, in somecases is may be desirable to omit the shelves.

[0056] Through the use of the present invention, a user can obtain theproper amount of compression that is required for each area of thetorso. Moreover, the multi-position closure 50 on the back enables theuser to increase or decrease the total amount of compression provided bythe garment 1 (such as when the size of the user's breasts increases ordecreases), while still maintaining the proper proportionality among thevarious regions. With a typical brassiere, a user who sought to increasethe amount of compression in one region, such as by making the garmenttighter in back, risked applying too much compression in a moresensitive region and thereby creating adverse consequences, such as theunwanted restriction of fluid flow.

[0057] The present invention seeks to avoid these shortcomings in theprior art, and provides an adjustable compression garment that can bemass-produced rather than having to be custom fit. In the presentapplication, however, only a preferred embodiment of the presentinvention has been disclosed and discussed, and it should be understoodthat the present invention is not limited to this (or any other)particular embodiment. On the contrary, the present invention isintended to cover all alternatives, modifications and equivalents thatmay be included within the spirit and scope of the appended claims.

What is claimed is:
 1. A brassiere comprising: a. an outer covering; b.a front panel for providing compressive support to breast tissue, saidfront panel including compression fabric and having an upper edge, afirst side edge, a second side edge, and a lower edge, and wherein saidfront panel is attached to said outer covering at least at said firstand second side edges, further wherein said front panel is moveablerelative to said outer covering along a portion of said lower edge; andc. a front shelf for providing upward compressive support to breasttissue, said front shelf being positioned proximate said lower edge ofsaid front panel.
 2. A brassiere of claim 1, further comprising a backpanel attached to said outer covering at said first and second sideedges.
 3. A brassiere of claim 2, wherein said front shelf extends alongsaid lower edge of said front panel from approximately said first sideedge of said front panel to approximately said second side edge of saidfront panel.
 4. A brassiere of claim 1, wherein said outer coveringincludes compression fabric.
 5. A brassiere of claim 1, wherein saidcompression fabric included in said front panel has a modulus in thelength dimension ranging from 1.0-2.75 pounds at 30% elongation and2.25-5.75 pounds at 60% elongation, a modulus in the width dimensionranging from 0.8-2.2 pounds at 40% elongation, a stretch in the lengthdimension ranging from 135-200% and a stretch in the width dimensionranging from 115-150%.
 6. A brassiere of claim 1, wherein saidcompression fabric included in said front panel has a modulus in thelength dimension ranging from 1.15-2.5 pounds at 30% elongation and2.7-5.45 pounds at 60% elongation, a modulus in the width dimensionranging from 1.0-2.0 pounds at 40% elongation, a stretch in the lengthdimension ranging from 150-183% and a stretch in the width dimensionranging from 120-145%.
 7. A brassiere of claim 1, wherein saidcompression fabric included in said front panel has a stretch in thelength dimension ranging from 135-200% and a stretch in the widthdimension ranging from 115-150%.
 8. A brassiere of claim 1, wherein saidcompression fabric included in said front panel has a modulus in thelength dimension of 1.0-2.75 pounds at 30% elongation and 2.25-5.75pounds at 60% elongation and a modulus in the width dimension of 0.8-2.2pounds at 40% elongation.
 9. A brassiere of claim 5, wherein said outercovering includes compression fabric having a modulus in the lengthdimension ranging from 0.5-1.5 pounds at 40% elongation and 1.0-2.0pounds at 60% elongation, a modulus in the width dimension ranging from0.2-1.0 pounds at 40% elongation and 0.5-1.6 pounds at 60% elongation, astretch in the length dimension ranging from 160-220% and a stretch inthe width dimension ranging from 120-170%.
 10. A brassiere according toclaim 1, further including at least two princess seams in said outercovering.
 11. A brassiere according to claim 2, wherein said back panelhas an adjustable closure for permitting a user to adjust the size ofthe brassiere.
 12. A garment for providing compressive forces to atorso, the garment comprising: a. an outer covering of compressionfabric, including front and back portions; b. one or more shoulderstraps for connecting said front portion of said outer covering to saidback portion of said outer covering; c. a front panel for providingcompressive support to at least a portion of the front of the torso,said front panel including at least one layer of compression fabric andhaving an upper edge, a first side edge, a second side edge, and a loweredge, and wherein said front panel is attached to said outer covering atleast at said first and second side edges, and wherein said front panelis moveable relative to said front portion of said outer covering alonga portion of said lower edge; d. a front shelf for providing upwardcompressive support to breast tissue, said front shelf being positionednear said lower edge of said front panel; and e. a back panel forproviding compressive support to at least a portion of the back of thetorso, said back panel including at least one layer of compressionfabric and having a first side edge and a second side edge, and whereinsaid back panel is attached to said outer covering at said first andsecond side edges.
 13. A garment of claim 12, wherein said at least onelayer of compression fabric in said front panel includes at least twolayers of compression fabric.
 14. A garment of claim 12, wherein saidouter covering includes a first side seam and a second side seam,further wherein said first side edge of said front panel is attached tosaid first side seam and said second side edge of said front panel isattached to said second side seam.
 15. A garment of claim 12, whereinsaid at least one layer of compression fabric for said front panel has amodulus in the length dimension ranging from 1.0-2.75 pounds at 30%elongation and 2.25-5.75 pounds at 60% elongation, a modulus in thewidth dimension ranging from 0.8-2.2 pounds at 40% elongation, a stretchin the length dimension ranging from 135-200% and a stretch in the widthdimension ranging from 115-150%.
 16. A garment of claim 12, wherein saidcompression fabric for said outer covering has a modulus in the lengthdimension ranging from 0.5-1.5 pounds at 40% elongation and 1.0-2.0pounds at 60% elongation, a modulus in the width dimension ranging from0.2-1.0 pounds at 40% elongation and 0.5-1.6 pounds at 60% elongation, astretch in the length dimension ranging from 160-220% and a stretch inthe width dimension ranging from 120-170%.
 17. A garment of claim 12,further including at least two princess seams in said outer covering.18. A garment of claim 13, wherein said at least two layers ofcompression fabric included in said front panel are attached to oneanother.
 19. A garment of claim 12, further comprising a pair of axillagussets for retaining tissue near a wearer's axillae, each of said pairof axilla gussets having a top edge and wherein the distance betweensaid top edge and the wearer's axilla when said garment is properlypositioned on the wearer is approximately 3.5-5 cm.
 20. A garment ofclaim 12, wherein said garment is designed to be worn by a human femaleand wherein said garment is sized so that the distance H between saidlower edge of said front panel and the wearer's navel when said garmentis properly positioned on the wearer is approximately 1-8 cm.
 21. Agarment of claim 20, wherein said distance H ranges from 1.5-5 cm.
 22. Agarment for providing a range of compressive forces to a human femaletorso, the garment comprising: a. an outer covering of compressionfabric, said outer covering including first and second side seams, aswell as first and second princess seams; b. a front panel of compressionfabric, said front panel being attached to said outer covering at saidfirst and second side seams; c. a back panel of compression fabric, saidback panel being attached to said outer covering at said first andsecond side seams; d. a first axilla gusset attached to said outercovering near said first side seam; e. a second axilla gusset attachedto said outer covering near said second side seam; f. wherein each ofsaid first and second axilla gussets provides a first level ofcompressive support to tissue near a wearer's axilla; g. wherein thecombination of said outer covering and said back panel provides a secondlevel of support to at least a portion of the back of the torso, saidsecond level of support being greater than said first level of support;h. wherein the combination of said outer covering, said front panel, andsaid back panel provides a third level of support to at least a portionof the side of the torso, said third level of support being greater thansaid second level of support; and i. wherein the combination of saidouter covering and said front panel provides a fourth level of supportto at least a portion of the front of the torso, said fourth level ofsupport being greater than said third level of support.
 23. A brassiereto be worn by a woman having axillae and an abdominal watershed, thebrassiere comprising: a. an outer covering made from a compressionfabric, said outer covering having a lower edge located about 1-8 cmabove the woman's abdominal watershed when the brassiere is properlypositioned on the woman; and b. a pair of axilla gussets, each havingupper edges located about 3.5-5 cm below a corresponding axilla when thebrassiere is properly positioned on the woman.
 24. A brassiere accordingto claim 23, further including a rear closure sized to extend betweensaid lower edge and a position in a range defined by the woman's fifthand eighth thoracic vertebrae, when the brassiere is properly positionedon the woman.
 25. A brassiere according to claim 23, further including afront shelf for providing upward compressive support to breast tissue ofthe woman.
 26. A brassiere according to claim 23, wherein said loweredge is located about 1.5-5 cm above the woman's abdominal watershedwhen the brassiere is properly positioned on the woman.
 27. A brassiereto be worn by a woman having axillae, torso side regions and a breastregion, the brassiere comprising: a. first and second axilla portions,each intended to be positioned proximate one of the axillae of the womanwhen the brassiere is properly worn, said first and second axillaportions providing a first level of compressive support; b. sideportions intended to be positioned over the woman's torso side regions,said side portions providing more compressive support than said firstlevel of compressive support; and c. a front portion intended to bepositioned over the woman's breast region, said front portion providingmore compressive support than said side portions.
 28. A brassiereaccording to claim 27, wherein said front portion includes a front shelffor providing compressive support to breast tissue of the woman.
 29. Abrassiere according to claim 27, wherein at least said side portions andsaid front portion are made from compression fabric.
 30. A brassiereaccording to claim 27, wherein said front portion includes a front shelffor providing compressive support to breast tissue of the woman.
 31. Abrassiere to be worn by a woman having an abdominal watershed andthoracic vertebrae, the bra comprising: a. an outer covering made from acompression fabric, said outer covering having a lower edge, whereinsaid outer covering is sized so that when said brassiere is properlypositioned on the woman said lower edge is positioned about 1-8 cm abovethe woman's abdominal watershed; and b. a rear closure sized to extendbetween said lower edge and a position in a range defined by the woman'sfifth and eighth thoracic vertebrae, when the brassiere is properlypositioned on the woman.
 32. A brassiere according to claim 31, furtherincluding a front panel having a front shelf for providing compressivesupport to breast tissue of the woman.
 33. A brassiere according toclaim 31, wherein said lower edge is positioned about 1.5-5 cm above thewoman's abdominal watershed when the brassiere is properly positioned onthe woman.
 34. A brassiere according to claim 32, wherein said frontpanel is made from a compression fabric having a modulus in the lengthdimension ranging from 1.0-2.75 pounds at 30% elongation and 2.25-5.75pounds at 60% elongation, a modulus in the width dimension ranging from0.8-2.2 pounds at 40% elongation, a stretch in the length dimensionranging from 135-200% and a stretch in the width dimension ranging from115-150%.
 35. A brassiere according to claim 31, wherein said outercovering is made from a compression fabric having a modulus in thelength dimension ranging from 0.5-1.5 pounds at 40% elongation and1.0-2.0 pounds at 60% elongation, a modulus in the width dimensionranging from 0.2-1.0 pounds at 40% elongation and 0.5-1.6 pounds at 60%elongation, a stretch in the length dimension ranging from 160-220% anda stretch in the width dimension ranging from 120-170%.
 36. A brassiere,comprising: a. an outer cover made from a compression fabric having amodulus in the length dimension ranging from 0.5-1.5 pounds at 40%elongation and 1.0-2.0 pounds at 60% elongation, a modulus in the widthdimension ranging from 0.2-1.0 pounds at 40% elongation and 0.5-1.6pounds at 60% elongation, a stretch in the length dimension ranging from160-220% and a stretch in the width dimension ranging from 120-170%; andb. a front portion attached to said outer cover and including acompression fabric having a modulus in the length dimension ranging from1.0-2.75 pounds at 30% elongation and 2.25-5.75 pounds at 60%elongation, a modulus in the width dimension ranging from 0.8-2.2 poundsat 40% elongation, a stretch in the length dimension ranging from135-200% and a stretch in the width dimension ranging from 115-150%. 37.A brassiere according to claim 36, further including a front shelf forproviding compressive support to breast tissue of a user.
 38. Abrassiere according to claim 36, wherein said outer cover furtherincludes: a. a lower edge that is positioned about 1-8 cm above a user'sabdominal watershed when the brassiere is properly worn; and b. a rearclosure sized to extend between said lower edge and a position in arange defined by the fifth and eighth thoracic vertebrae of the wearerof the brassiere, when the brassiere is properly worn.
 39. A method ofcontrolling lymphedema in a person having axillae, a side torso regionand a chest region, comprising the steps of: a. applying a first levelof compression adjacent the axillae; b. applying a second level ofcompression to the side torso region, wherein said second level ofcompression is greater than said first level of compression; and c.applying a third level of compression to the chest region, wherein saidthird level of compression is greater than said second level ofcompression.
 40. A method according to claim 39, wherein said steps a, band c involve applying, respectively, said first, second and thirdlevels of compression using a garment made including compression fabric.41. A method according to claim 39, wherein said step c involvesapplying compression inwardly toward the chest region and upwardlyrelative to breast tissue projecting from the chest region.
 42. Abrassiere according to claim 1, further including at least two princessseams in said front panel.
 43. A garment of claim 12, further includingat least two princess seams in said front panel.